Why new or emerging cities need

to be different in India?

Amit Samarth

UNHABITAT, State of the World Cities, 2008-09

Our collective purpose as a society

• To be economically progressive• To be socially cohesive• To promote health and well-being• To enable individuals to achieve

their intellectual and physical potential

• To ensure that citizens today and tomorrow will be able to enjoy the basic amenities of life in a sustainable and eco-friendly way

Ecological model of Human Health

Human health should be seen in a physical, social, behavioural, and ecological context.

Health promotion activities should involve other sectors making a contribution to health, such as education, food, nutrition, and environment.

Source: Barton and Grant, 2006

What have our cities achieved?

• Drivers of economic growth• Hubs of world class education,

commerce and specialized health care services

• 400 million are already living in Urban India

• 590 million will be living in urban India by 2030

• 68 million plus cities by 2030• 13 cities with more than 4 million

people• 6 Megacities with more than 10

million peopleSource: India’s Urban Awakening. Building Inclusive cities , Sustaining Economic Growth

Cities in India are of great contrast

• 80 million or more urban poor live in cities of India

• Informal sector one of the key drivers of cities economic growth

• Maharashtra, Andhra Pradesh, Uttar Pradesh and West Bengal have highest slum population

• Mumbai, Delhi and Kolkata have highest slum population

• Growing inequalities and growing exclusion

• Poor living conditions• Poor health outcomes

Source: India Urban Poverty Report 2009

Poor health indicators of the urban poor

• High infant and maternal mortality• High water-borne diseases• High vector borne disease like

malaria and dengue• Higher incidence of chronic diseases

like hypertension, diabetes and coronary heart disease

• Poor occupational health• Higher mental illnesses• Road traffic injuries

Urban areas in India have better specialized healthcare services but facilities for promotive and primary care are non-existant

In Andhra Pradesh, there are 7500 slum localities but there are only 250 Urban Healthcare Centres

Source: Living conditions in 8 cities of India. NFHS-III Survey 2005-06

Urban environment affects each one of us

• Only 2 per cent cities have low air pollution on the basis of PM10

• In 80 per cent of cities at least one criteria pollutant exceeded the annual average ambient air quality standards

• Exponential growth in private vehicles in last few years -17 million vehicles in last 7 yrs

• Personal vehicles – cars and two-wheelers -- use up more than 75 per cent of the road space, but meet only 20 per cent of the city’s commuting demand

Source: State of Air Pollution in Indian Cities 2007, Centre for Science and Environment

Are we creating more space for cars rather than for our

own self?

Promoting and protecting health has become a challenge

• Lack of good footpaths• Absence of dedicated

cycling tracks• Lack of green spaces• Lack of sports facilities• Lack of social space• Changing food systems

and nutritional transition

• Food inflation

Threats to cities due to climate change

• Urban flooding due to heavy rainfall

• Flooding provides opportunities for breeding of disease carrying insects such as mosquito

• Lack of adequate water can compromise hygiene and thus increasing rates of diarrhoeal disease

• Decreased crop yields can stress food supplies

What we need to do in

emerging cities of India?

To promote and protect

health….!

Healthy Urban

Population

Good urban governance & healthy urban

planning

Improve health and

social equity

Improve living and working

condition

Improve availability

and access to healthcare

services

Embedding health in all

policies

Make Healthy Choice – The Easy Choice

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Health and Social equity leading to

Healthy Urban Population

Good water quality

Housing

Waste management

Cheap and nutritious

Access to food

Roads

Green Spaces

Cheap transport

Cheap

Clean

Information & Education

Social & Cultural activities

Sanitation

Good air quality

NutritionInfrastructure

Energy

Community Basic services

Lightings

Education and employment

Healthcareservices

Government services

Healthy Environment

Reduce carbon emissions and air pollutants Increased physical activity Improved social capital

Provide better public transport

Facilitate more walking and cycling

Improve Transportation

Reduced levels of cardiovascular diseases Reduce obesity Reduced respiratory diseases Improved mental health and decreased depression

Source: Margalit Younger, Heather R. Morrow-Almeida, Stephen M. Vindigni, Andrew L. Dannenberg. The Built Environment, Climate Change, and HealthOpportunities for Co-Benefits

Improved air quality Increased physical activity Decreased heat island effects

Provide convenient and well lit stairs Natural ventilationIncrease facilities such as parks, and opportunities for physical exercise

Better buildings and land use

Reduced levels of cardiovascular diseases Reduced respiratory diseases Improved mental health and productivity Reduced susceptibility to heat related illnesses

Source: Margalit Younger, Heather R. Morrow-Almeida, Stephen M. Vindigni, Andrew L. Dannenberg. The Built Environment, Climate Change, and HealthOpportunities for Co-Benefits

Improved and better balanced nutrition Reduce carbon emissions

Sustainable agriculture Promote locally grown food Provide healthy food options and information Reduce demand for meat consumption

Improve nutrition

Reduced obesityReduced levels of cardiovascular diseases and diabetes

Source: Margalit Younger, Heather R. Morrow-Almeida, Stephen M. Vindigni, Andrew L. Dannenberg. The Built Environment, Climate Change, and HealthOpportunities for Co-Benefits